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Switch: My thoughts on a long-overdue “read”

SwitchWith two kids—one three, one three months—I’ve had little time to read books lately. I’m still reading loads, mind you. But mostly just articles pulled through Feedly and Zite. Finding time to sit down and read long-form narrative isn’t easy. So my books-to-read backlog has been growing.

Recently, I learned about a new audiobook service called—somewhat uncreatively—Audiobooks.com. I found it while searching for a streaming audiobook service similar to Rdio and Netflix (both of which I subscribe to). My thinking: why not listen to books whenever I have the time, such as while taking my sleeping son for a walk in the stroller.

Unfortunately, Audiobooks.com didn’t quite meet my needs, as you basically get one audiobook a month for $15—and I’d like to “read” more than that. But it got me excited about the possibility of audiobooks, which led me to explore books offered through Overdrive by Toronto Public Library. I was initially skeptical, but my wife prompted me to dig deeper, and I’m glad I did. It’s a goldmine.

One of my findings: Switch, by the Heath brothers, who also wrote the excellent Made to Stick. I recently finished it and, overall, was equally as impressed as I was with Made to Stick. While some of the information wasn’t new (in particular, stuff related to ground covered in-depth by Robert Cialdini), it was woven together in a useful framework, and chock full of valuable ideas and stories that made them stick.

So, here’s my very brief summary of how to make a switch:

  1. Direct the rider (note: the “rider”—basically, the rational mind—and “elephant”—basically, emotional desires—come from the book The Happiness Hypothesis)
    1. Follow the bright spots: Often, when we’re challenged with solving a challenge, we tend to look for problems that are inhibiting the solution. But there’s another approach: find what is working and try to replicate it. For example, if you want customers to buy more products, you might focus on all the myriad reasons they’re not buying more from you. Another approach would be to identify customers who are buying more from you, and see why it’s working. Then try to replicate it.
    2. Script the critical moves: “Eat healthier” is a vague statement with a lot of wiggle room. (Especially since what’s considered healthy differs depending on which fad diet might be popular this month.) “Drink two glasses of water every day as soon as you wake up” is a specific action. Often, people get stuck in analysis paralysis, or get overwhelmed with options. To overcome this, script the critical moves: tell them exactly what to do, and make it specific, with black-and-white edicts that leave no wiggle room.
    3. Point to the destination: What does success look like? Paint a clear picture of what will happen if people act out the critical moves. For example, continuing with the healthier eating theme, you could have them purchase an outfit that’s the size they want to fit into, so they can clearly visualize what success will look like.
  2. Motivate the elephant
    1. Find the feeling: If, like me, you work in marketing, you understand this implicitly. You can’t rationally convince people to change their behavior, or do what you want them to do. You need to make them feel something. Once you hook them with feeling, you can talk to them intellectually. Exactly what the feeling is will depend on the change you’re trying to accomplish. If we stick with the health theme, telling people “eat healthier or your cholesterol will go up” won’t be as effective as talking to people about how sad it would be for them to die of a heart attack and miss their children’s graduations and weddings, and the birth of their grandchildren. A better line for a campaign might be: “Cut out red meat. Your grandchildren want to meet you.”
    2. Shrink the change: One of the great examples in this book—and there are many—talks about a study of customer loyalty cards that found a card for a car wash requiring 8 stamps for a free wash performed worse than a card requiring 10 stamps but with 2 pre-stamped. (That’s a mouthful. Sorry. No time for much editing these days either!) The reason? Big changes spook the elephant. While you still needed 8 washes to get a free wash, in the former case you needed to fill 100% of your stamps, while in the latter you were already 20% of the way there. Going back to our health examples, we might ask people to eat just one more fruit per day. It seems like a small thing, but it’s the kind of change that’s easy to do, and ultimately small changes can snowball into big ones.
    3. Grow your people: This topic is one that dovetails with Robert Cialdini’s discussions of commitment and consistency. Just as you can make change seem easier by shrinking it, you can also make it seem easier by growing the people who will tackle it. A lot of this comes down to identity. For one thing, people who think of themselves as capable of making change are more likely to make it. So, for example, your company can rebrand everyone in the organization “change engineers” or “innovators,” rather than the dull “employees.” Another key point here is, as Cialdini noted, that people will act in ways that are consistent with their identity. So if you find the bright spots (see above), and point out to people that they have previously done things in alignment with the changes you want to make, they will subsequently be more likely to make similar changes. For example, again going back to the topic of health, if you give people a FitBit that shows they’re already hitting 7,500 of their target 10,000 steps a day without every stepping foot in a gym, they’ll start to see themselves as physically active and be more likely to walk the extra steps to hit the 10,000. (This example also illustrates that the information helps shrink the change, because they were already 75% of the way to their goal and didn’t even know it.)
  3. Shape the path
    1. Tweak the environment: The Heath brothers repeat, and rightfully so, that what often seems like a people problem is actually a situation problem. So if you can change the situation—and especially the environment—you can often change people’s behavior. A simple example for health is simply eliminating all junk food from someone’s fridge and cupboards to make it more difficult for them to eat unhealthy snacks. Less willpower is needed when temptation has been removed.
    2. Build habits: It can take time to create habits, which means changed behavior can often slip back. However, there are ways to instil instant habits using “action triggers.” For example, in the book, the Heath brothers talk about a safety supervisor at a manufacturing plant who painted a blue line around the perimeter, within which safety gear had to be worn at all times. The blue line acted as an action trigger, prompting people to put on their safety gear habitually. In relation to health, an action trigger could be setting out your gym clothes the night before, prompting you to put them on when you wake up and head to the gym.
    3. Rally the herd: This topic also overlaps with Cialdini, who talks about the importance of social proof in influencing people’s behavior. Basically, we look to others for behavioral guidance, and do this more often when things are uncertain. Since change creates lots of uncertainty, people will look to others and see how they’re reacting. If nobody else is making the change, you can be pretty sure it won’t catch on. For this reason, you can’t just think about individuals when trying to create change. You need to think about social cues that people will give to each other, and ensure alignment. For example, if we wanted to influence 40-year-old men to see their doctor for a cholesterol test, we could promote something like, “80% of men 40 and over see their doctor for a cholesterol test—have you?” Perhaps we could also use a social media campaign with checkins at the doctor for a cholesterol test, demonstrating that this is something people’s friends are doing.

All in all, Switch was a worthwhile read—um, I mean, listen—and I’m thrilled that audiobooks can allow me to start consuming great books again. I’m now working my way through Superfreakonomics, so I may have another blog post book review coming soon.

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Fancy Hands: after two months, what’s my take on this virtual personal assistant service?

Disclaimer: Links to Fancy Hands within this article are special referral links—effectively a Fancy Hands coupon. If you click the links and sign up, you get 50% off your first month and I get a $10 credit. This doesn’t really help me unless I continue to think the service is great and continue using it, so it in no way affects my opinions below. But I’m noting it for full transparency. Now, on to the post. 

Two months ago, I wrote about a new service I’m using called Fancy Hands. The service makes virtual assistants app-like. You literally get an app on your mobile device to which you post requests that virtual personal assistants fulfill. At the time, I had just started using it. So what’s my experience after two months?

Since I’ve started using Fancy Hands, I’ve used it to complete 34 requests. For these, they’ve placed 32 calls, sent 4 emails, saved me $10 (by finding discounts for things I want them to buy), spent 54 minutes on the phone and saved me 16.8 hours (by their calculations). I believe my total cost for their services was $115, or about $6.85 per hour saved. (And yes, the fact that they report all of this information on my dashboard makes a quantified-selfer like me quite happy.)

So, quantitatively, Fancy Hands continues to make sense to me. In fact, along the way I’ve increased my service level from 5 tasks per month to 15. And for now, that seems about the right number. So what am I primarily using it for?

  • Gift purchases. I think Fancy Hands has made me more thoughtful, because no longer is cash simply my default gift due to time constraints. I can tell Fancy Hands about the person I want to buy gifts for, they can recommend good options for these people, and then they can purchase the ones that I approve.
  • General purchases. Sometimes, I need a specific item but don’t have time to go searching for it. I can ask Fancy Hands to find me options for those items, including those that are highly rated, and then approve them for purchase. One advantage here is that they can also search for or come across discounts, thereby helping to save me money overall.
  • Research and data entry. Overall, I’ve found the quality of assistants to be very high. On several occasions I’ve asked them to conduct research, including in fairly specialized subjects, and they’ve returned good results. They’ll also put those results into structured data formats such as spreadsheets. This can be a huge time-saver. My sense is that Fancy Hands may use a person or algorithm to get the right requests to the right people. For example, if an assistant has expertise in digital media, they might direct a related request to them. (But this is just an assumption.)
  • Finding and booking contractors. One thing I wish Fancy Hands offered was physical as well as virtual service. For example, if I want to change all the lightbulbs in my house to LEDs, it would be great if I could post that request somewhere and have it done. (I’ve tried to find a good service for this in Toronto, but those that exist do not seem to have much traction.) However, Fancy Hands can help me find, book and post ratings for contractors, which I have had them do with good success.
  • Feedback. Sometimes, you need feedback. For example, I’m currently working on a hobby project called WellPilot (I wrote more about this here and here). I’ve asked Fancy Hands to give me feedback on aspects of the site such as usability. This feedback has been very useful.
  • General digital tasks. One that was particularly useful for me was having Fancy Hands add my digital signature to a huge batch of documents that I needed to sign related to a business transaction. I had reviewed the documents in PDF format, but would have had to print, sign and fax each one. Instead, I sent them to Fancy Hands with a digital signature and had them add the signatures for me.

Overall, I would (and regularly do) recommend Fancy Hands to anyone who’s trying to optimize their time. Fancy Hands’ motto is “do what you love and let us do the rest.” I plan to continue exploring how to best make that happen, and keep looking for opportunities to outsource to them.

 

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Making WellPilot smarter: scoring condition-treatment relationships

A few weeks ago I posted about WellPilot, a hobby project to evaluate what really works for maintaining health and extending healthy lifespan. At that time, it was pretty basic in its evaluation of condition-treatment relationships. It simply counted the quantity of research articles supporting a relationship, but ignored their quality. For example, a cell culture experiment would be counted as equal to a randomized, double blind, placebo-controlled trial.

I’ve now addressed this with a more sophisticated condition-treatment scoring algorithm. For example, if you look at what WellPilot has discovered about Parkinson’s disease and melatonin, you’ll see that the highest scored article is randomized, double blind and placebo-controlled. WellPilot has now scored over 1.5 million research articles across nearly 9,000 condition-treatment relationships. (I set up a WellPilot Twitter account where it now randomly announces different relationships that it’s analyzed.)

However, there’s still much to do to make WellPilot’s results more meaningful and reliable. For one thing, it doesn’t know whether an article reflects a positive or negative finding for a condition-treatment relationship. It just knows the quantity and, to an extent, the quality of the studies conducted. One of my next areas of focus is helping to train the system by involving users in crowdsourcing feedback on research articles supporting a condition-treatment relationship. WellPilot could then, theoretically, be programmed to learn what signals to look for in evaluating research.

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WellPilot.com: My hobby project to guide health maintenance (and possibly life extension)

I’m a bit of a health nut. I pop lots of supplements. I’m also into life extension, and am signed up for cryonics.

So it was a bit frustrating recently when, after my wife and I completed a 23andMe genetic test, we found no easy-to-use sources of information on how to prevent some of the conditions for which we were genetically at risk.

I think that 23andMe is working to close this gap with the acquisition of CureTogether. But that site uses patient self-reporting. I like the idea of crowdsourcing treatments, but also like the idea of using more traditional data sources. And I wish someone could assemble an end-to-end treatment and prevention platform, including data-driven guidance, subscription-based products (to avoid the annoyance of reordering), and integrated testing to ensure the interventions are working.

Nerd that I am, I’ve started to take a stab at this. It’s a hobby project that I call WellPilot. The initial functionality works like this:

  • Search WellPilot for conditions or treatments
  • Click on a condition  (for example, Parkinson’s), and see what treatment and prevention is supported by research (currently just non-drug interventions)
  • Or click on a treatment (for example, Green tea), and see what conditions it can treat or prevent, according to research

You can also then click through and see all the research supporting condition-treatment relationships (for example, coffee for Parkinson’s disease).

Currently, the data is imported from PubMed, and the analysis is very rudimentary—it uses research volume for each condition-treatment pair. Moving forward, I aim to improve this, to account for such factors as study type (human, animal, cell, etc.), study strength (randomized, placebo controlled, etc.) and reputation (impact factor, etc.).

I would also like to eventually add crowdsourcing, similar to CureTogether, but that’s a longer-term ambition. And I’d like to add product subscriptions—to provide premium supplements at wholesale prices, delivered to your door, based on strong evidence. And the list of feature ideas keeps growing.

For now, though, it at least provides a starting point if you want some guidance for what interventions can address conditions you’re concerned about. Check it out and let me know what you think.

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Fancy Hands review: finally, a virtual assistant that’s as easy to use as an app (literally)

The Fancy Hands app is like a magic to-do list: add stuff to it, and other people get it done

The Fancy Hands app is like a magic to-do list: add stuff to it, and other people get it done

Disclaimer: Links to Fancy Hands within this article are special referral links—effectively a Fancy Hands coupon. If you click the links and sign up, you get 50% off your first month and I get a $10 credit. This doesn’t really help me unless I continue to think the service is great and continue using it, so it in no way affects my opinions below. But I’m noting it for full transparency. Now, on to the review. 

A few weeks ago, in one of my regular rants about personal effectiveness, I half-jokingly told my wife that I wanted a to-do list that worked like magic: I would add stuff to it, then other people would get that stuff done for me.

The universe granted my wish.

A few days later, reading an article on several businesspeople’s killer apps for personal effectiveness, I read about Fancy Hands. It sounded almost exactly like what I had described: post a request, and a virtual assistant gets it done (with few limitations—most critically, the task must be completable with either a computer or a phone, as they don’t do physical tasks yet).

I was intrigued. I have often thought about hiring a personal assistant, inspired by books like 4-Hour Workweek to outsource anything that doesn’t require my direct effort to complete. But I’ve yet to find a service that’s cost-effective and efficient. Most virtual assistant services require an upfront purchase of hours, which can be a significant cost—especially if you fail to use them all. And if I want to hire a personal assistant directly, it can get expensive—plus, being just one person, they can’t scale to tackle multiple tasks simultaneously when needed. For one-off tasks, I’ve used Fiverr, but it’s not efficient for regular use (it takes too much time to find the right people you can trust), and their mobile experience leaves much to be desired.

So Fancy Hands seemed just right. They offer subscription packages, with 5 tasks for $25 being the starting point. While this works out to $5 per task, it drops to about $2.60 per task at the 25 tasks for $65 level. Plus, from my experience, some tasks—such as scheduling appointments—are free. And the ease of use is superb: through either the app or the website, just submit a request and someone acts on it.

Buying time

So I signed up. And, while my wife often thinks it’s nuts, I’ve since used Fancy Hands to research a new shampoo for my daughter, reschedule a hair appointment, buy me shirts (they’ll purchase anything up to $100 on your behalf), do research for a business venture, do research for floor treatment, and research and purchase a tongue pad to help a new pair of shoes fit better.

All in all, their dashboard tells me I saved 30:13 with those requests. At $25, that works out to about $0.83 a minute—which, if I want to compare, is significantly less than the rate I can charge for consulting work, meaning there is plenty of ROI potential if I use Fancy Hands to liberate time for paid work.

And the quality? Overall, excellent. For almost every request, Fancy Hands’ assistants go above and beyond, following my directions exactly or recommending alternatives if my original request can’t be fulfilled for reasons beyond their control (such as a product I asked for not existing). While I’m still working to identify the best tasks to delegate, I have few qualms that requests I submit will be appropriately addressed.

I’ve also noticed some more intangible benefits. For one, I feel more at ease just knowing Fancy Hands is available—it’s like a pressure valve when work and family obligations build up. Another is that it’s training me to better delegate, as I’m a perfectionist and tend to avoid delegating due to fears about quality and loss of control. And it’s forcing me to regularly think about the value of time, and how my time can be best spent (note: the founder of Fancy Hands, Ted Roden, tries to never do the same thing twice).

Bottom line: subscribing to Fancy Hands can buy you time. While there’s certainly room for improvement—I wish they could run physical errands, for example—I’m definitely planning to continue my subscription, and probably increase it. So far, they’re living up to their motto: do what I love and let them do the rest.

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There’s no Moore’s Law for people

Moore’s Law continues to be applied broadly with fairly good success. First we thought that only the number of transistors on a chip grew exponentially. Then we started to see the same phenomena in other technology. Then we extended it to natural phenomena, even cosmology, and saw some success there.

But I’m not sure it applies to individual people. Because the older I get, the more I realize people’s life trajectories are difficult to predict (including my own). I’ve seen people going down a path to criminality suddenly find religion, and people dedicated to a career path suddenly drop out of the rat race and work for social justice causes.

In hindsight, there may have been signs. Perhaps the changes were clear reactions to the previous situation, or perhaps everything was rooted in a common cause (psychological or otherwise) that, if more fully understood, would allow more complete prediction.

But maybe, on an individual basis (although possibly less so for groups), people are inherently unpredictable. We’re chaotic systems, fully of randomness and irrationality, and as such can have unintended and unpredictable responses to stimuli over the long-term. The best we can do, perhaps, is try to understand ourselves, chart a course and try to consciously navigate it, doing our best to hold true to our vision while adapting as needed.

As for forecasting the future, perhaps we should stick to easy things like the emergence of artificial superintelligence and the fate of the universe, and expend less energy on the possibly impossible task of anticipating someone’s destiny based on what we know about them now.

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Vitamin D is essential for health, and you’re probably deficient

Sun and sunflower

Your body generates vitamin D in sunlight, but you’re unlikely to have anywhere near levels associated with improved health

I’m not a good bleeder. I once tried to give blood and they unhooked me because they thought I’d pass out. I also nearly passed out when my wife had a c-section and the anesthesiologist butchered her increasingly bloody hand while jamming in the IV.

So, while I’m working to overcome my blood phobia, it was no easy task for me to bleed all over the mail-in vitamin D test (that’s not an affiliate link, just a really cool product) I recently ordered. But I had to, because for the past three months I’ve been taking over 11 times the recommended daily allowance of vitamin D. And I needed to know whether it was working—and whether I was taking too much.

This was all part of my 2013 New Year’s health resolutions. One of my goals was to begin more aggressive supplementation, and I now take Life Extension Foundation multivitamins, omega 3 supplements, coenzyme Q10, SAMe and vitamin D3 supplements. My total vitamin D3 intake is 7,000 IU, which is about 11.7 times higher than Health Canada’s RDA of 600 IU, and 3,000 IU higher than their tolerable upper intake level of 4,000 IU.

Vitamin D benefits: evidence mounts

Why so much vitamin D? There is now a plethora of evidence linking vitamin D3 deficiency with poorer health, including cardiovascular disease, diabetes, depression, cancer, respiratory infection, stroke and overall higher mortality. There is also evidence of a protective effect for vitamin D against Multiple Sclerosis, and a link between higher serum vitamin D and lower Parkinson’s disease risk.

In northern areas—such as Toronto, where I live—vitamin D deficiency is more common due to less sunlight, and this can be exacerbated by sunscreen use. So I decided to follow Life Extension Foundation’s advice, take 7,000 IU total each day, and test my blood levels regularly to stay safe.

The optimal level of serum vitamin D appears to be 50-80 ng/mL. Above 100 ng/mL is associated with increased risks of atrial fibrillation. Since I’m taking 11.7 times the RDA, you would expect that I would be at least in the healthy range.

So am I?

Lots of supplements, yet still suboptimal

Nope.

According to my serum 25-hydroxyvitamin D test results, I’m at 40 ng/mL. Not entirely deficient, but definitely not optimal.

And I’m certainly not alone. In fact, 85% of Life Extension Foundation members were found in a 2010 study to have suboptimal vitamin D levels. And these people are fanatical about their health.

So if you aren’t already taking vitamin D supplements and regularly testing your blood levels (as challenging as that can be), you might want to consider it. Vitamin D is cheap, and while only a blood test can say for sure, my experience suggests you’re highly unlikely to overdose—and much more likely to be deficient.

Image credit: Lυвαιв

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Denied life insurance: the follow-up to my successful appeal

About a year ago, I wrote about a scary life insurance denial and subsequent successful appeal.

The denial was based on a misinterpretation of a liver enzyme panel. At the time, I argued that elevated liver enzymes were likely related to high-intensity resistance training, which research has shown can increase certain liver enzymes that are sometimes but  clearly not always associated with pathology.

Recently, I put that theory to the test. My physician ordered another blood test. Two weeks before I took it, I changed my workout routine to include only bodyweight resistance training (pushups, sit-ups, etc.). And for a few days before the blood test, I avoided strenuous exercise completely.

I changed nothing else in my diet or lifestyle.

Lo and behold, my results were fine. Liver enzymes previously elevated and of concern were in the normal range.

My doctor said that it’s likely I’m one of those people who will have ups and downs on liver enzyme tests over time, and that this isn’t a concern except for insurance applications.

I, however, am fairly confident that this moderately controlled test supports my original hypothesis.

So if you’ve been denied life insurance due to the results of a liver panel, consider whether your workouts are to blame, and appeal accordingly.

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Further forays into personal outsourcing: first use of a virtual assistant

I’m a big fan of Timothy Ferriss’ 4-Hour Workweek, which aligns with my drive for ever-increasing personal effectiveness. The overall approach of define, eliminate, automate and liberate makes sense to me, and the use of technology and outsourcing to free up time for higher-order and higher-value activities is something I pursue aggressively.

Yet, despite this, I’ve yet to engage a virtual personal assistant. I’ve explored the options, but often felt services required too much commitment up front, such as buying a bucket of monthly hours to use. I have used vendors such as Grocery Gateway to outsource specific tasks. But nothing more comprehensive.

A small task: research sunscreens

Last week, I took my first small step into using a virtual personal assistant by engaging someone on Fiverr to conduct research into face sunscreens. Possibly not the most compelling subject, but something I had on my to-do list that could be easily outsourced with minimal risk. I gave instructions consisting primarily of the following:

  1. Research the best day face cream that meets the following criteria:
    1. Efficacy: Provides good UVA/UVB protection (minimum SPF of 15)
    2. Safety: Has a good health profile with low toxicity; look at http://www.ewg.org and http://goodguide.com
    3. Availability: Is ideally available at Well.ca (from where I order personal care items)
  2. Write a summary of the research and recommend three day creams that best meet the above criteria

Today, in response to the request, I received the following research, which I’m posting verbatim. Judge the quality for yourself:

There are several things to consider when selecting a good day cream for the face. Ultraviolet A and B protection and toxicity of ingredients are two factors that should be considered over price. However, finding a good face day cream that is affordable, low in toxicity, great for all skin types, and provides adequate UVA and UVB protection is a definite bonus. Three face day creams that meet all these requirements are:

  • Cetaphil Daily Facial Moisturizer with Sunscreen Broad Spectrum SPF15: This moisturizer is suitable for all skin types and is priced under $15. It is fragrance free and does not clog the pores. It has an overall health rating of 3. The ingredients of concern that determined its health rating are octocrylene, glyceryl stearate/peg-100 stearate, phenoxyethanol, benzyl alcohol, tocopheryl acetate, and triethanolamine.
  • Desert Essence Gentle Nourishing Day Cream with SPF 15: This face day cream is affordably priced at under $20 and is suitable for all skin types. It has an overall health rating of 3 and the ingredient of concern is sodium hydroxide.
  • La Roche-Posay Hydraphase UV with SPF 30: This intense formulation that is a light and non-clogging moisturizer is suitable for all skin types. It costs about $40 and is doubled the SPF of most face day creams at SPF 30. The product has an overall health rating of 4 and the main ingredient of concern is fragrance. However, other ingredients of concern are homosalate, octisalate, octocrylene, dimethicone, peg-12 dimethicone, triethanolamine, and phenoxyethanol.

Positive return on investment

Overall, I’m satisfied with the results. I already knew about the Desert Essence product, but the other two are new to me. The research addressed exactly what I had asked, and all the products are available at Well.ca.

The cost of outsourcing this task was $5. Placing the order took about 5-10 minutes (and will hopefully become more efficient when Fiverr rolls out a better mobile experience). The work would likely have taken at least 30 minutes. A minute of my time is worth at least $2.50 and $4.17 in the open market, based on the rate I can bill as a consultant. If I take an average of $3.34, my total cost was no more than $38.40, and my saving in time was worth $100.20. So my return on investment was about 161%.

I imagine that this should improve further as I become more efficient at the process and identify more complex tasks to outsource. But 161% ROI is already compelling. And while I could have done the work myself at no monetary cost, finding such time between my day job (for which I travel regularly), my hobby projects and my family (one three year old, another child on the way) isn’t easy.

The next step for me is to identify more tasks I can outsource, while working to build trust with specific personal assistants. Trust is obviously critical for personal tasks, and I wonder whether Fiverr (which is more about single transactions) provides the right platform for building long-term, trusted relationships. Time will tell but, for now, it’s a great platform for further experiments in outsourcing, which I intend to continue conducting vigorously.

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Marketing to Dr. Watson: Here’s how we might use data to influence machines

(Cross-posted from Klick Health blog.)

This past week, IBM’s Jeopardy-winning AI Watson furthered its medical career with new jobs that could significantly disrupt healthcare and permanently shift pharmaceutical marketing practices.

That might seem dramatic given Watson’s humble start as a game show contestant. But ever since it (I keep struggling to not say “he”) trounced the world’s best Jeopardy players, I’ve followed its rapid progress from Alex Trebek’s stage through medical education and now into gainful employment. With each step, I’ve become increasingly convinced that Watson and systems like it will drive or at least facilitate fundamental changes in healthcare—and healthcare marketing. So how might we respond?

From Jeopardy to oncology

For those who don’t know, it was reported this week that Watson will officially begin work helping doctors diagnose and treat patients, while helping insurers evaluate treatment coverage. This follows many months of Watson getting educated in medicine. For oncology, Watson was trained by the world’s best oncologists and has effectively consumed, as I understand it, every piece of useful data on the topic, including the latest research—with which it stays continuously up to date. It then uses the same approach it used on Jeopardy to apply that knowledge to diagnosis and treatment.

Physicians give Watson a case, just as Trebek gave it an answer, and Watson gives them diagnostic and treatment recommendations with varying probabilities of correctness. (Example: A 95% chance that, based on the information provided, a person has prostate cancer.) Physicians then choose to agree or disagree with Watson. But, as one oncologist noted during a pilot, it’s hard to disagree with a system that knows exponentially more than you, is trained by the world’s best physicians, and is completely up to date with the latest research.

And Watson isn’t the only system showing promise at improving diagnosis and treatment while reducing costs. Also this past week, Indiana University researchers reported on predictive modelling techniques that improve patient outcomes by 40% and reduce treatment costs by 50%.

Towards a new discipline: “Artificial Intelligence Optimization”

While the creators of these systems take pains to say they’re not displacing doctors, just augmenting them, I consider that political correctness rather than fact. With soaring costs, doctor shortages and challenges for doctors to keep pace with the increasing volume of research and data, it seems inevitable that a shift to artificially intelligent doctors will occur—especially since their “brain” can be distributed as software or made available via the cloud. (At the most controversial end of the spectrum, venture capitalist Vinod Khosla says machines will do 80% of what doctors currently do.)

Such a shift is already happening with web- and smartphone-based consumer tools. For example, Symcat provides patients with free big data-driven diagnoses, Medify provides patients with disease and treatment guidance based on evaluation of published research, and Treato, which I’ve written about previously, analyzes social media conversation to determine what real patients think of treatments.

If the shift towards machine-driven diagnostics and treatment, and away from physician-driven, continues, it could have a significant impact on pharmaceutical marketing. How do you influence an algorithm?

From my perspective, the common thread through these services is their reliance on data–structured and unstructured. Hence the focus of pharmaceutical marketing might need to shift increasingly towardsmaximizing the generation and digital distribution of data that improves appropriate diagnosis and treatment of patients who can benefit from an intervention. For example, investment might be warranted in:

  • Additional clinical trials that result in published data Watson and other systems can use for diagnostic, treatment and insurance recommendations
  • Encouraging patients to talk openly (in a compliant way, of course) in public forums about their positive experiences with a treatment, so social media aggregators pick up and analyze the posts
  • Data monitoring to identify and address prospective negative data that could adversely impact treatment usage

Of course, these are just some early thoughts. I imagine that as this trend hastens, we’ll develop dedicated disciplines to optimize data for artificial intelligence and analytics engines the way we currently optimize content for search engines. The good news is that, overall, this should improve the application of data to diagnosing and treating patients, while helping address ballooning healthcare costs. The challenge is that the path is uncertain; Watson is an amazing diagnostician, but it can’t predict the future.

At least not yet.

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